title: Straddle injuries in female children and adolescents: 10-year accident and management analysis.
abstract: OBJECTIVE
  To analyze unintentional straddle injuries in girls with regards to epidemiology, etiology and injury management.
  
  
  METHODS
  The hospital database was retrospectively reviewed (1999-2009) for female patients managed for genital trauma. Patients were evaluated based on age, causative factors, type of injury, area of genitals affected, management and outcomes.
  
  
  RESULTS
  Straddle injuries were documented in 91 girls with age ranging from 1 to 15 y (mean = 6.3 y; median = 6.1 y). The causes of injuries were falls at home (n = 31) or outdoors (n = 27), and sport activities (swimming pool n = 11, skating n = 11, bicycle n = 9 and scooter n = 2). Most of the injuries were lacerations. Injuries involved major labia (n = 56), minor labia (n = 45) and introitus vaginae (n = 15). Twelve children received outpatient treatment. Inspection under anesthesia was performed in 79 patients, with 76 requiring sutures. While hematuria was observed in 18 patients, cystoscopy did not reveal lesions in the urethra or bladder. Associated injuries were femur fracture (n = 1), lower extremity lacerations (n = 4) and anal lesions (n = 2). Follow-up investigations were uneventful; however one patient developed a secondary abscess and another secondary hyperplasia of the labia minor.
  
  
  CONCLUSIONS
  Falls and sports are major causes of straddle injuries with a peak at the age of six years. Lacerations are the most common injuries and often require surgical management. Urinary tract injuries and other associated injuries are relatively uncommon in girls with straddle injuries.
authors.affiliation: Department of Pediatric- and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, A-8036, Graz, Austria, Amulya.saxena@medunigraz.at.
authors.forename: Amulya K
authors.initials: AK
authors.lastname: Saxena
authors.forename: Maria
authors.initials: M
authors.lastname: Steiner
authors.forename: Michael E
authors.initials: ME
authors.lastname: Höllwarth
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005836:Genitalia, Female / Q000293:injuries*; D006801:Humans; D007223:Infant; D013178:Sports Medicine